Disease Management Programs for Patients With Asthma in Germany: A Longitudinal Population-Based Study

Abstract

BACKGROUND:The primary aim of the disease management program (DMP) for patients with asthma is to improve health outcomes and to reduce costs. Five years after its introduction in Germany, no consensus has yet been reached as to whether DMP has been effective in reaching these goals. OBJECTIVE: To evaluate the DMP for asthma in Bavaria using routinely collected subject medical records. METHODS: A longitudinal population-based study encompassing over 100,000 DMP participants between 2006 (when the program began) and 2010. RESULTS: The prescription rate of oral corticosteroids dropped from 15.7% in 2006 to 13.6% in 2007, and again from 7.5% in 2008 to 5.9% in 2010 (P < .001). The proportion of subjects with asthma selfmanagement education increased from 4.4% to 23.4% (P < .001). Utilization of an individual asthma action plan increased from 40.3% to 69.3% (P < .001). Hospitalization decreased from 2.8% to 0.7% (P < .001). CONCLUSIONS: In the first 4 years of DMP there was an improvement in pharmacotherapy and patient self management. The proportion of subjects requiring hospitalization decreased. Our results suggest that the German DMP for asthma has been effective in enhancing the quality of care in regard to an improved symptom frequency, adherence to guidelines, pharmacotherapy, and hospitalization.

Physician Perspectives on the Burden and Management of Asthma in Six Countries: The Global Asthma Physician Survey (GAPS)

“…This may reflect the debate about the extent of the benefits of written management plans [35] since these benefits were first presented in 2004 [36]. The proportion of physicians employing written plans in Germany recorded in our study (37%) is lower than published data from the German Disease Management Programme (DMP) evaluation would suggest [37]. Another study reported this discrepancy in use of written plans between German patients enrolled in the DMP and those not enrolled [38], demonstrating both the need to assess a representative population when calculating overall population estimates and the potential benefit of enrollment on such a structured programme.…”

Prescription patterns, adherence and characteristics of non‐adherence in children with asthma in primary care

“…Promising results have been shown by targeting new adherence interventions, like speech recognition telephone calls, or by other e‐health tools, or disease management programmes . Another opportunity to improve adherence is to enhance the promising pharmacist‐led targeted interventions in patients with asthma.…”

The evaluation of a remote support program on quality of life and evolution of disease in COPD patients with frequent exacerbations

“…Recommendations for the use of specific support programs for patients with COPD are based on experience with other chronic diseases such as diabetes [20], coronary artery disease [21], and asthma [22]. Studies investigating the utility of such programs for COPD reported heterogeneous conclusions, and meta-analyses have argued that more studies are needed [23, 24].…”